Pain is one of the oldest medical complaints, but treatment has always followed a one-size-fits-all approach. For centuries, doctors assumed that what worked for men would work just as well for women. However, research now confirms that women experience pain more intensely and don’t always respond to painkillers the same way.
That means millions of women suffer longer, take higher doses, or don’t get relief at all. And the worst part? Experts still don’t fully understand why.
Women are more likely to suffer from chronic pain conditions like migraines, fibromyalgia, and irritable bowel syndrome. Despite this, doctors often dismiss their pain, leading to delays in treatment that make their conditions worse. On top of that, common painkillers like ibuprofen, opioids, and steroids don’t work as effectively in women as they do in men.
The Medical Research Gap That Left Women Behind
Before 1993, women were routinely left out of clinical drug trials funded by the National Institutes of Health. Researchers worried that hormonal fluctuations and pregnancy risks would complicate their studies.
Olly / Pexels / Elizabeth Losin, a neuroscientist studying pain perception, says this gap in research has left us with an incomplete understanding of how women process pain.
Instead of accounting for these differences, they tested medications on men and assumed women would respond the same way. That assumption turned out to be dangerously wrong.
Many drugs prescribed today were developed based on male physiology, leaving women at a disadvantage when it comes to effective pain relief. Without proper research, doctors are left guessing about the right dosages or even the right drugs for female patients.
Why Pain Medications Don’t Work as Well for Women
Experts believe that sex hormones play a major role in how women process pain and respond to medication. Estrogen, a hormone that women produce in higher amounts, slows digestion and affects how drugs are absorbed. It also impacts how medications move through the bloodstream and bind to proteins, which can change how effectively they relieve pain.
Women’s immune systems are also more active than men’s. While this helps them fight infections, it also increases inflammation, making pain worse. This could explain why women need higher doses of pain medication and use them for longer periods. Two common anti-inflammatory drugs - glucocorticosteroids and NSAIDs - have been found to provide more relief for men than women.
That means many women are relying on medications that don’t fully work for them.
Opioids and Women
Polina / Pexels / Amy Baxter, a former pediatric emergency physician and pain researcher, says that while opioids may not be as effective in women, they are still more likely to be prescribed them than men.
The opioid crisis has put a spotlight on how differently men and women respond to these powerful painkillers. Some studies suggest that women have fewer mu-opioid receptors - the proteins that opioids bind to for pain relief. If true, this means women may need higher doses to get the same level of relief as men.
Other studies suggest the opposite - that women require lower doses of opioids because they experience more side effects like nausea and dizziness.
This could be because doctors perceive their pain as more emotional or distressing rather than treating it as a biological response. Either way, women are left with fewer effective options for managing their pain.
What Needs to Change Now?
The good news is that awareness is growing, and researchers are finally prioritizing sex differences in medical studies. The pharmaceutical industry is starting to recognize that drugs need to be tested on both men and women to be truly effective. But there is still a long way to go.
Doctors need better training on how pain manifests differently in women. They should be more willing to adjust medications, explore alternative treatments, and take female patients seriously when they say their pain is not going away.